If you’re preparing for a knee replacement or have recently undergone the procedure, you might be feeling a bit uncertain about the recovery process. Knee replacements are one of the most common surgeries performed, and while the procedure offers significant pain relief, the recovery journey can be just as crucial for a successful outcome. Understanding what to expect during the recovery period can help ease any concerns and better prepare you for the road ahead.
Managing Pain and Discomfort Post-Surgery
It’s important to know that experiencing pain after surgery is normal and expected, and it doesn’t necessarily signal a problem. The knee has undergone a major transformation, and your body is adjusting to the new joint. Think of it as a mini construction zone inside your knee—your surgeon has just replaced a significant part of your anatomy!
To manage pain, your doctor will prescribe medication as needed. It’s often recommended to take these pain medications about an hour before your physical therapy sessions to get the most out of your time with the therapist. Along with medication, ice, elevation, and rest are essential to managing swelling and discomfort. Swelling is normal, and you may notice it not just around the incision and knee joint but also in the hip area (due to a tourniquet used during surgery) and in the foot and ankle (due to gravity).
Discharge and Initial Therapy
In most cases, unless complications arise, patients are discharged from the hospital on the same day as their knee replacement surgery. Before leaving, the medical team will ensure you can safely get up and walk using an assistive device, such as a walker. Depending on your doctor’s preferences, you will either begin physical therapy at an outpatient clinic the day after surgery or receive in-home therapy for the first one to two weeks.
In-Home Therapy and Early Recovery
If you opt for in-home therapy, services like those offered by Athletico allow you to remain with the same therapist throughout your entire recovery process—this continuity can help ensure a smooth and consistent healing journey. These therapists can also perform some basic care, such as changing bandages and taking blood pressure measurements. However, keep in mind that you may need a nurse for medication management or other specialized needs.
A key component of home therapy is regaining your knee’s range of motion. During therapy, the therapist will work with you to bend and straighten the knee, helping you rebuild flexibility and strength. While your therapist will guide you through this process, it’s important to work on these movements on your own between sessions as well.
Transition to Outpatient Physical Therapy
After completing any home-based therapy, you will transition to outpatient therapy, typically within a few weeks of surgery. During the first session, your therapist will perform a thorough evaluation, which includes assessing your range of motion and strength, understanding your goals, and developing a customized home exercise program. If you’ve been receiving in-home therapy through Athletico, this evaluation will already be completed, and you can begin more focused therapy right away.
What Happens During Outpatient Therapy?
Physical therapy sessions in an outpatient clinic typically begin with cardio exercises to improve circulation and get the knee moving. A stationary bike or Nu-Step machine may be used to promote gentle movement and blood flow.
Following the cardio warm-up, your therapist will perform manual therapy on the knee. This often includes massage techniques to reduce swelling and mobilizations of the kneecap to prevent the formation of scar tissue. Scar tissue can limit the knee’s ability to bend and straighten properly, so it’s important to address this early on.
Strengthening exercises will become the focus of later sessions. These exercises are designed to strengthen the muscles around the knee—primarily the quadriceps, hamstrings, and calves. Functional strengthening is especially important, as it helps patients perform everyday activities, such as walking, going up and down stairs, and getting in and out of a car, without an assistive device.
At the end of each therapy session, your therapist may use modalities such as ice or electrical stimulation to reduce swelling and alleviate pain. This varies depending on the therapist’s approach, but the goal remains the same: improving mobility and decreasing discomfort.
Key Milestones During Recovery
Throughout physical therapy, your therapist will help you reach specific milestones, which are indicators that you’re progressing well. Some of the important milestones include:
- Full knee extension: Achieving full knee extension (the ability to straighten your knee completely) is essential for normal walking mechanics and avoiding a limp.
- 90-degree knee flexion: Reaching 90 degrees of knee flexion (bending the knee) is typically targeted within the first two weeks following surgery.
- 120-degree knee flexion: By about six weeks, achieving 120 degrees of knee flexion is a common goal.
How Long Does Outpatient Therapy Last?
Outpatient physical therapy typically lasts anywhere from several weeks to a couple of months, depending on your progress and recovery goals. You will be discharged from physical therapy once your knee’s range of motion and strength allow you to carry out daily tasks and exercises safely. Keep in mind that while physical therapy may end, the recovery process continues, and it can take anywhere from 6 months to a year to feel fully “normal.” That doesn’t mean you won’t be able to do everything you want to do before this—just that you might experience occasional soreness or stiffness along the way.
Don’t be alarmed if you hear noises in your knee—these sounds are normal and don’t mean something has come loose. Your knee is simply adjusting to the new joint, and the noises should diminish as you continue healing.
Pre-Hab: Preparing for Surgery
One of the most beneficial steps you can take to improve recovery outcomes is pre-habilitation, or “pre-hab.” Pre-hab involves engaging in physical therapy before your knee replacement surgery to improve your strength and range of motion, which can lead to a quicker and more successful recovery post-surgery. Strengthening the muscles around the knee and improving flexibility can reduce pain, help you adapt to post-surgery mobility, and sometimes even delay the need for surgery in certain cases.
The Bottom Line: Recovery Takes Time, but You Can Do It!
Knee replacement recovery is a gradual process that requires patience, consistency, and dedication. By following your prescribed physical therapy regimen and setting realistic goals, you’ll work toward regaining full mobility and strength. While you may experience some discomfort, it’s important to understand that it’s all part of the healing journey.
If you’re considering knee replacement surgery or are already recovering from the procedure, working with a skilled physical therapist and staying active during the rehabilitation process are key steps to reclaiming your mobility and returning to the activities you love. And remember, the road to recovery may be long, but with the right approach, it will lead to a stronger, more functional knee and an improved quality of life.
